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The COVID-19 Vaccine Paradox

By 28/04/2020April 29th, 2020No Comments

The COVID-19 Vaccine Paradox

Published on April 28, 2020

A call to accelerate human-focussed medical research

by Prof Amanda Ellison and Dr Kit Byatt

We find ourselves in a time of global health emergency, one that will challenge our healthcare, social fabric and economy for years to come. The choices we make now are born out of great and immediate need. There are however patterns emerging in the scientific response that will have far reaching consequences for how we progress medical science in the future.

The University of Oxford is currently following in the footsteps of a research facility in Seattle, USA, by trialling a COVID-19 vaccine in humans. Given that the vaccine uses pre-existing technology and contains components known to be safe to use in people, the opportunity to fast-track trials straight into humans has been engaged. As Dr John Tregoning of Imperial College, London points out, this “is a race against the virus…for the benefit of humanity”.

Ordinarily such vaccines would be tested in at least two species of animals – usually mice or rats, followed by dogs or other animals – in preclinical studies in an attempt to test safety and effectiveness for humans, before permission is granted to proceed to human trials, taking up to two years to complete. This data essentially informs how these animals respond to the target treatment; the cost of this insight is their suffering. An unavoidable consequence is the potential rejection of treatments failing these tests because they are ineffective or unsafe in animals. However, they might be perfectly safe in humans and vital to the breakthrough humanity urgently needs. Herein lies the paradox.

However, even when people are involved in the trial and an effective treatment is identified, it can still take a further 18 months to ensure the vaccine is valid and safe in the longer term through Phase II and III trials, which then trigger further animal experiments before the treatment is finally approved. Given the global emergency and our knowledge of the components of the possible vaccines under review, it seems in this case that the most agile, effective and humane approach is to bypass animal testing altogether.

More work can be done to improve the process however. Non-animal technologies and new approach methodologies can be deployed to further accelerate the discovery of novel human targeted treatments. And through the collection of interdisciplinary patient information not restricted to their biology but also psychosocial, economic and other background factors, we can easily begin to understand who the virus attacks outside of the obvious epidemiological age and relevant disease markers. We will also be able to develop a predictive model for each candidate vaccine as to who they will work for, when, for how long and why. Developing better understanding of gender differences for example, or efforts that bring us closer to personalised treatments is where time and expertise must now be focussed. Such investigations are uniquely human, without recourse to animal experiments which are simply not relevant to anything other than the understanding of the mechanism of action in that particular animal.

Although parallel animal research is taking place for example in the Porton Down Research Facility, we applaud the prescience that has allowed this new human-focussed course of action. COVID-19 is a national and global emergency still in a very acute phase. Undoubtedly, some good will come out of researchers’ experience during this crisis, and already practice has undergone a small step change. However, we must do better – and urgently.

Utilising human relevant test subjects – i.e. people – in the fight for a COVID-19 vaccine sets a powerful precedent for testing treatments where the components of technology and resultant medicines have already been established as safe in humans.

We now need the vision to adopt this approach for all human illnesses – from coronavirus to cancer, dementia to diabetes. Something good can come from the COVID-19 emergency. Animal Free Research UK is calling for a change of mindset and regulations to enable accelerated treatments for humans which are more effective, cheaper and delivered through kinder science.

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